Spontaneous skull fractures are particularly interesting due to the vague circumstances of their occurrence. Apart from scientific and professional significance, fetal fractures may have medico-legal implications for obstetricians and midwives because their spontaneous occurrence in the majority of cases is exceedingly difficult to prove. The aim of the article is to investigate some new risk factors and mechanisms of spontaneous fetal skull fracture occurrence and to recommend measures for their prevention. Based on two case reports of spontaneous depressed fetal skull fractures under different circumstances authors have discussed potential new risk factors and relevant pathophysiological mechanisms of spontaneous skull fractures. An understanding of risk factors and the mechanism(s) contributing to spontaneous skull injuries, may provide medical professionals with significant knowledge in assisting both the prevention of new cases and in court proceedings. The purpose is to assist those obstetric practitioners accused of potential malpractice, in addition to medical experts involved in adjudicating any potential cases for malpractice. The authors anticipate that with new evidence and additional practical recommendations will initiate a broad professional discussion which might help many obstetric providers to pay attention to risk factors and mechanisms, so that potential fetal/neonatal skull fractures could be avoided. Additionally, the benefits for obstetric practitioners who are accused of potential malpractice and for medical experts who may adjudicate it, cannot be understated.